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Retrospective Application of Risk Scores to Unruptured Anterior Communicating Artery Aneurysms.
Wójtowicz, Katarzyna; Przepiorka, Lukasz; Kujawski, Slawomir; Maj, Edyta; Marchel, Andrzej; Kunert, Przemyslaw.
Afiliación
  • Wójtowicz K; Department of Neurosurgery, Medical University of Warsaw, 02-097 Warsaw, Poland.
  • Przepiorka L; Department of Neurosurgery, Medical University of Warsaw, 02-097 Warsaw, Poland.
  • Kujawski S; Department of Exercise Physiology and Functional Anatomy, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-077 Bydgoszcz, Poland.
  • Maj E; Second Department of Clinical Radiology, Medical University of Warsaw, 02-097 Warsaw, Poland.
  • Marchel A; Department of Neurosurgery, Medical University of Warsaw, 02-097 Warsaw, Poland.
  • Kunert P; Department of Neurosurgery, Medical University of Warsaw, 02-097 Warsaw, Poland.
J Clin Med ; 13(3)2024 Jan 30.
Article en En | MEDLINE | ID: mdl-38337482
ABSTRACT

BACKGROUND:

Treatment decisions for unruptured intracranial aneurysms (UIAs) pose a challenge for neurosurgeons, prompting the development of clinical scales assessing hemorrhage risk to provide management guidance. This study compares recommendations from the PHASES and UIA treatment scores (UIATS) applied to anterior communicating artery (AComA) UIAs against real-world management.

METHODS:

While UIATS recommends management, for PHASES, an aneurysm with score of 10 or more was considered "high-risk". Analysis involved assessing the concordance in each group alongside comparison to real-word management.

RESULTS:

Among 129 patients, 46.5% were observed and 53.5% were treated. PHASES scores were significantly higher in the treatment group (p = 0.00002), and UIATS recommendations correlated with real-world decisions (p < 0.001). We observed no difference in the frequencies of UIATS recommendations between high- and low-risk groups. When comparing the UIATS and PHASES, 33% of high-risk aneurysms received a UIATS conservative management recommendation. In 39% of high-risk aneurysms, the UIATS recommendation was not definitive. Conversely, 27% of low-risk aneurysms obtained a UIATS UIA repair recommendation. Overall, concordance between PHASES and UIATS was 32%.

CONCLUSIONS:

Significant discordance in therapeutic suggestions underscores the predominant influence of center experience and individual assessments. Future studies should refine and validate decision-making strategies, potentially exploring alternative applications or developing tailored scales.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Guideline / Prognostic_studies / Risk_factors_studies Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Suiza